May/June 2009

The Crime Victims Report

19

Silent Injuries Among Child Sexual Abuse

Professionals, Part I
by Robert Emerick*
Editors Note: The second installment of this article will appear in a
forthcoming issue of CVR.
Have you ever studied the effects of
prosecuting these cases?, asked a male
prosecuting attorney after listening to
the lecture entitled Offender Dynamics and the Process of Victimization.
(Robert L. Emerick, National College
of District Attorneys, 1990.) Elaborating, he explained it was professionally
helpful to understand child sexual abuse
from the perspectives of the offender
and victim. However, he believed the
seminar failed to address a critical concern. He explained that his exposure
to child sexual abuse cases was causing personal changes that forced him
to question whether the changes he
experienced were normal or abnormal.
The attorney was not the last seminar
attendee to ask this question.
In 1999, Arizonas sexual assault
conference planners posed the question and a request. The committee
asked for a lecture addressing secondary trauma to child sexual abuse professionals. Qualifying their request,
the conference planners requested a
seminar content that unifies the literature describing potential health
challenges to child sexual abuse professionals, namely:
Countertransference (Herbert J.
Freudenberger and Arthur Robbins,
The Hazards of Being a Psychoanalyst, 66 The Psychoanalytic Rev.
275296 (1979));
*Mr. Emerick has developed and managed
treatment programs for child sexual abuse survivors and perpetrators in the United States and
Canada. His clinical and research practice yielded
abuse history factors among adolescent and adult
sexual abuse survivors that identify children at
higher risk to act out sexually. In addition to his
clinical and research practice, he teaches child
sexual abuse professionals about sex offender
investigation, treatment, and supervision, and
has made presentations on Silent Injuries to
child sexual abuse professionals at various state,
provincial, and national conferences.
For more information regarding Silent Injuries and to complete the Silent Injuries Questionnaire, go to www.SilentInjuries.com.

Burnout (Christina Maslach and

Susan E. Jackson, The Measurement
of Experienced Burnout, 2 (2) J. of
Occupational Behav. 99113 (Apr.
1981));
Vicarious traumatization (Lisa
McCann and Laurie Anne Pearlman, Vicarious Traumatization: A
Framework for Understanding the
Psychological Effects of Working
With Victims, 3 (1) J. of Traumatic
Stress (Jan. 1990));
Post-traumatic stress disorder
(American Psychiatric Association,
Diagnostic and Statistical Manual of
Mental Disorders (4th ed. American
Psychiatric Assoc. 1994)); and
Compassion fatigue (Charles R. Figley, Compassion Fatigue: Coping
With Secondary Traumatic Stress
Disorder in Those Who Treat the
Traumatized (1995)).

Critical Questions
Two critical questions emerge when
one considers the existing literature
that discusses potential health challenges to child sexual abuse professionals, namely:
1. Is child protection different from
other health care tasks and, if so,
does it affect different disciplines in
different ways? (D.M.B. Hall, Is
Protecting Children Bad for Your
Health?, 90 Arch. of Disease in
Children 1105106 (2005).)
2. Other than exposure to traumatized
clients, what leads to compassion
fatigue? (Richard Adams, Joseph
Boscarino, and Charles Figley,
Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study, 76 (1) Am.
J. of Orthopsych. (2006).)
Together, these questions ask whether providing health care services to
sexually abused children exposes the
CSA professional to a unique traumatic
stressor and, if so, are the effects common to all responding professionals?
As a diverse professional grouping, CSA professionals unify their
professional training to identify, con-

front, change, and control a dark

side of humanity. (Toni Farrenkopf,
What Happens to Therapists Who
Work With Sex Offenders?, 18 J. of
Offender Rehabilitation (1992).) This
dark side is the child molesters sexual
and social deviance. Sexual deviance
is sexual behavior for which there is
a legal, cultural, and clinical concern,
such as child molestation, rape, exhibitionism, and lust murder. Social
deviance is the chain of cognitive and
behavioral elements that enable sexualizing, targeting, and exploiting a child.
(S. Yochelson and S. Samenow, The
Criminal Personality, Vol. I-II (Jason
Aronson 1976, 1977); H.R. Nichols
and I. Molinder, Multiphasic Sex
Inventory Manual: A Test to Assess
the Psychosexual Characteristics of
the Sexual Offender (1984); R.A. Lang
and R.R. Frenzel, How Sex Offenders Lure Children, Sexual Abuse: A
J. of Res. & Treatment (1988); L. Berliner and J.R. Conte, The Process of
Victimization: The Victims Perspective, Child Abuse & Neglect (1990).)
Together, the child molesters social
and sexual deviances cluster to form a
unique extreme traumatic stressor.

Silent Injury Questionnaire

The author developed the 257-item
Silent Injuries Questionnaire (SIQ) to
investigate the cognitive, emotional,
social, and sexual effects exposure to
social and sexual deviance has on CSA
professionals and to identify practices
that can mediate ones injury risk.
The response option to the 220 Silent
Injury items and 10 Social Professional Desirability (SPD) Scale range
from onestrongly disagree; to
sevenstrongly agree. The response
comprises a seven-point Likert scale.
Higher scores indicate a greater agreement that the statement is applicable
to the respondent. The remaining true/
false items address demographics (16
items) and self-care (11 items).

See CHILD SEXUAL ABUSE, next page

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20

The Crime Victims Report

CHILD SEXUAL ABUSE, from page 19

Respondents
Most (79.2%) of the 1,033 anonymous respondents were female. Law
enforcement was the only male-dominated profession (54.2%). The largest
professional sample was sexual assault
nurse examiners (SANEs) (n = 200) and
the smallest was probation/parole (n =
15). The largest proportion of professionals (45%) provides CSA casework less
than half-time, and one-third respond to
CSA cases three-quarter time or more.
As expected, a greater proportion
of women (44%) than men (20.5%)
reported a childhood sexual abuse history. Most professionals (60.6%) were
married at the onset of their CSA profession. Of the 626 professionals who
were married at the time their CSA service delivery started, 19.5% reported
they have divorced their spouse. Most
CSA professionals (70.3%) reported
they are parents. Of the 729 parents,
45.1% reported one or more children
are currently less than 12-years-old.
Urban living was more frequently
reported (63.2%) than rural living.

Boundary Violations
Child sexual abuse is a pervasive
social problem shrouded by mythology.
(Roland C. Summit, The Child Sexual
Abuse Accommodation Syndrome, 7
Child Abuse & Neglect (1983).) Child
molester mythology creates artificial
boundaries. Boundaries can be defined
physically, such as erecting a fence
to define the limits of two adjacent
properties, or psychologically, such as
stereotyping to simplify, categorize,
and define the limits of two adjacent
lifestyles. By categorizing people, we
are able to think about them and predict their behavior more easily. (Henri
Tajfel, Cognitive Aspects of Prejudice, 25 J. of Social Issues (1969).) Do
CSA professionals create self-protective boundaries that artificially protect
them from exposure to deviance? And,
if so, what are the subsequent effects
when the boundaries are violated?
Adaptive Change. To investigate the
question, 12 items were drafted to examine three hypothesized boundary violations (BVs) the CSA professional may
experience while providing his or her
professional services. The domains are
psychological, social, and sexual. The

hypothesis was that each boundary violation may create cognitive dissonance that
requires the professional to make adaptive
changes. (Leon Festinger, A Theory of
Cognitive Dissonance (Stanford University Press 1957).) Professionals failing to
adaptively change were expected to report
significantly greater cognitive, social, and
sexual health challenges. Higher scores
indicate the professional reported exposure to social and sexual deviance that
defies mythology and may require adaptive change. Data analyses reduced the 12
exploratory BV items to a single 10-item
scale. The BV scale scores range from 10
to 63 (M = 25.95; SD = 10.12). Considering the diverse professional populations
that responded to the items, Cronbachs
Alpha is a moderately strong 0.7032. Data
analysis revealed victim-offender therapists, law enforcement personnel, and
offender therapists scored significantly
higher than SANEs, victim therapists, support personnel, CPS workers, and child
advocates at the 0.05 level.
Psychological Boundary Violations.
Psychological boundary violations (PsychBVs) are defined as self-protective beliefs
a CSA professional may hold about child
sexual abuse that are likely challenged
by professional experiences. The beliefs
create a false sense of social and sexual
distinction between CSA professionals and
child molesters. Most CSA professionals
(77.2%) acknowledge one or more PsychBV. Overall, the scores for the PsychBV
subscale range from 3 to 20 (M = 7.27;
SD = 3.85). The average score among
males (m = 9.00; sd = 4.43) is significantly
greater than the average score among
women (m = 6.81; sd = 3.55), t(1,031) =
7.64 < 0.000000). It is not surprising that
the two professions having the greatest
exposure to child molesters (e.g., offender
therapists and victim/offender therapists)
score highest on the PsychBV scale.
Social Boundary Violations. Social
boundary violations (SocBVs) are
defined as CSA case fact situations causing the professional to withdraw from
an assignment due to social familiarity
with the child victim and/or offender.
Social familiarity may occur via social
or professional relationships. Most CSA
professionals (71.7%) are unchallenged
by social boundary violations. As a subscale, scores ranged from 2 to 14 (M =
4.61; SD = 3.47). SocBV scores vary
significantly among the professions and
the greatest mean score was observed
among child advocates.

May/June 2009
Sexual Boundary Violations. Sexual boundary violations (SexBVs) are
defined as CSA professional experiences
that cause the professional to view pornography belonging to a child molester
and/or experiencing sexual arousal while
performing a professional service. Overall, 43.9% of CSA professionals reported
their professional responsibilities cause
them to view pornography belonging
to a child molester. This CSA casework
responsibility is not equally distributed
across the various professions. Law
enforcement and prosecuting attorneys
are the two professions most frequently
called upon to perform this task. Overall,
28.5% of the professionals acknowledged their professional experiences
have caused sexual arousal. Generally,
males reported greater vulnerability to
this boundary violation than their female
colleagues. Among men and women, the
professions most frequently experiencing this violation are law enforcement,
prosecutors, offender therapists, and
offender/victim therapists. Most CSA
professionals (57.7%) are challenged
by sexual boundary violations. As a
subscale, scores ranged from 5 to 35
(M = 14.07; SD = 6.89). SexBV scores
vary significantly among the professions and the professions reporting the
greatest vulnerability to this violation
were law enforcement and prosecuting
attorneys.

Silent Injury Scale

Submitting the 61 investigative
Silent Injury (SI) items to factor analysis with varimax rotation yielded a
three-factor solution that accounted
for 72.49% of the response variance.
The three factors are:
1. Cognitive and social distress (25
items);
2. Consensual sexual touching and
intrusive case fact memories (seven
items); and
3. Sexual response injuries (10 items).
Items with a factor loading less than
0.40 were omitted. Items loading on
more than one factor were assigned to
the factor with the greatest loading.
Scale scores range from 44 to 254 (M =
116.81; SD = 45.96). The items are adequately related (Cronbachs Alpha =
0.9576). A higher score corresponds
with greater cognitive, social, and
See CHILD SEXUAL ABUSE, page 29

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May/June 2009
CHILD SEXUAL ABUSE, from page 20

sexual challenges. The scale is devoid

of gender and profession bias.
The SI items were classified according to the respondents reported incidence rates:
Predictable experiences are items
acknowledged by 90% to 100%;
Frequent experiences are items
acknowledged by 80% to 89%;
Probable experiences are items
acknowledged by 70% to 79%;
Potentially problematic experiences
are items acknowledged by 60% to
69%; and
Symptomatic experiences are items
acknowledged by less than 59%.
Cognitive and Social Distress Subscale.
The 25 items in the cognitive and social
distress subscale describe a broad range of
psychological and social challenges that
CSA professionals attribute to their professional responsibilities. The item with
the greatest loading on this subscale reads:
I wish thoughts about child sexual abuse
cases that I have transcribed, investigated,
prosecuted, or counseled did not bother
me so much. Among all professionals,
almost three-fourths of the professionals
(72%) acknowledged this post-service
delivery challenge. Thematically, the cognitive and social effects to CSA casework
can be summarized as follows. Predictable
experiences are auditory cues stimulating case fact memories and transient
depression. Frequent experiences are
general auditory cues stimulating anger,
bothersome intrusive case fact memories,
deliberate efforts to erase memories, and
having case-related thoughts that one is
unable to disclose to others. Probable
experiences are wishing case fact memories were less bothersome, injured social
trust, and dreading new case assignments.
Potentially problematic experiences are
auditory cues related to family and friends
provoking anger, intrusive case fact memories disruptive to family activities, and
questioning ones coping skills. Symptomatic experiences are experiencing terror at
the sight of a new case file, intrusive case
fact memories stimulated by the sight of
children and/or olfactory cues, dissociative response to case facts, and injured
social relationships.
Case Fact Memories Stimulated by
Consensual Touching Subscale. The seven
items comprising the case fact memories
stimulated by consensual touching

The Crime Victims Report

(CFMSCT) subscale describe consensual
sexual touches that provoke intrusive case
fact memories. The item with the greatest loading on this subscale reads: The
sensation of my partners genitals in my
hand or mouth brings about unwanted
child sexual abuse case memories. Overall, more than one-quarter (27.3%) of
the respondents acknowledge one or
more consensual sexual touches stimulate intrusive case fact memories. Data
analysis did not demonstrate a significant
relationship between ones profession and
subscale score. Women scored significantly higher (m = 13.35; sd = 8.86) than
did men (m = 11.61; sd = 7.47), t(1,031) =
2.65 (p < 0.01). However, when the
comparison is limited to no child sexual
abuse history (NCSA) professionals, the
average score among males (m = 11.24;
sd = 7.26) and the average score among
females (m = 11.94; sd = 7.80) are not
significantly different, t(627) = 1.03
(p > 0.05). It is important to note that vulnerability to consensual sexual touching
provoking intrusive case fact memories
is significantly related to an increasing
terror experience upon new case assignments. Professional history factors that
are related to consensual sexual touching
stimulating case fact memories include
the number of years responding to CSA
cases, proportion of professional time
committed to CSA cases, and number of
boundary violations.
Sexual Interest and Response Injuries.
Ten items coalesce to measure sexual
interest and response injuries, the third SI
subscale. The item with the greatest loading on this subscale reads: My interest
in sex has diminished because of sexual
issues that have evolved from my job.
Overall, one-quarter of the respondents
reported their professional experiences
caused sexual injuries and reduced their
interest in sex. There is no evidence of
gender (t(1,031) = 0.07 (p > 0.05)) or
profession (F(9, N = 1,033) = 0.97, p >
0.05) bias. Professional history factors
that increase ones vulnerability to sexual
interest and sexual response injuries
include beginning CSA service delivery
before age 40, receiving CSA cases without pre-case assignment training, and the
number of boundary violations.

Variables
Demographic variables unrelated to
SI score include community living environment, gender, marital status, profession, education, age, and the number

29

of years responding to CSA cases. Factors influencing SI scale score include

social-professional desirability scale
score, boundary violation score, age
at career onset, history of childhood
sexual abuse, administrative guidance,
family support, and self-care practice.
A linear relationship is observed
between BV scale score and SI score.
The average score among minimal violations is less than the average score
among moderate violation professionals, which is less than the average score
among problematic violation professionals, (F(2, N = 1,033) = 52.64, p <
0.000000.) This observation indicates
CSA professionals may harbor mythical attitudes about child molesters
that provide a self-protective boundary. When these mythical boundaries
are violated via exposure to social/
sexual deviance as it manifests within
the child molester, the professional is
required to make adaptive cognitive
changes. Professionals who unsuccessfully integrate their exposure to deviance report increasing disruption to
their social and sexual adjustment.
Service Delivery Starting Age. Professionals beginning their CSA service delivery before age 40 are more vulnerable to
injury than their colleagues who provided
their first CSA service after age 40 (F(2,
N = 1,029) = 8.29, p < 0.0005). It is noteworthy to observe there is not a significant
relationship between social desirability
scale score grouping and ones age grouping at the onset to their CSA profession. In
turn, it appears life experience favorably
serves the CSA professional.
Services Proportion. The proportion of ones professional services that
are committed to CSA cases affects
SI score (F(2, N = 1,024) = 4.82, p <
0.01). Professionals who reported their
CSA responsibilities comprise less than
half their professional services are less
vulnerable to injury (M = 111.83; SD
43.40) than professionals who reported
CSA cases comprise 75% or more
of their professional responsibilities
(M = 121.09; SD 48.57) at the 0.05 level.
This observation is consistent with past
observations noting professional diversity can mediate ones vulnerability to
CSA case-related injury risks.
Face-to-Face Contact. Exposure to
CSA cases via face-to-face contact with
children and perpetrators appears to pose
See CHILD SEXUAL ABUSE, next page

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30

The Crime Victims Report

CHILD SEXUAL ABUSE, from page 29

more health challenges than does exposure

to only perpetrators. The average SI score
among professionals having face-to-face
contact with both populations is greater
(M = 118.76; SD = 45.97) than the mean
score among professionals having only
face-to-face contact with perpetrators (M =
102.03; SD 42.56). Professionals having
face-to-face contact with only children
do not differ significantly from the two
groupings setting the extreme scores (F(2,
N = 956) = 4.25, p < 0.05).
Abuse History. A child sexual abuse
history significantly affects ones SI scale
score. NCSAH professionals averaged
109.41 in comparison to the average
score of 128.34 among CSAH professionals, t(1,031) = 6.60 (p < 0.000000).
Accepting a CSA position because of
ones abuse history appears to increase
injury vulnerability. The average score of
124.29 among CSAH professionals who
reported their motivation to accept a
CSA professional position is unrelated to
their abuse history is less than the average score of 142.44 among CSAH professionals who attributed their decision
to accept a CSA position to their abuse
history, t(358) = 2.91 (p < 0.005). Not
all CSAH professionals reported vulnerability to case fact situations stimulating
intrusive personal abuse memories. In
fact, 28% reported exemption from this
challenge. The average SI scale score
DOMESTIC VIOLENCE, from page 28

for handling domestic violence cases.

Prior to this, a police officers response
was to take the angry batterer away
from the scene to cool off or walk
around the block, or the officer would
attempt some form of mediation. If the
aggressor violated a restraining order,
then existence of mandatory or presumptory arrest policies is probably a
deterrent. (http://www.Sen.CA.gov/ftp/
sen/SOR/ARCHIVE/_7ISS07.HTM.)
Reforms Implemented. The laws on
DV in California have been changing
gradually, as reforms in criminal and
family law have been implemented.
There has been increased educational
training for law enforcement officers
and health care providers to deal with
victims and abusers, and a number of
bills have been passed. These changes,
funded largely by federal assistance

among professionals unchallenged by

personal abuse memories is less than
the average score among professionals
experiencing personal abuse memories,
t(369) = 8.15 (p < 0.000000). Abuse
history dynamics that were related to
increased vulnerability to personal abuse
memories being stimulated by ones
professional services were being abused
by more than one person and excessive
force to assure compliance.

Self-Care Practices
Self-care is an ongoing dynamic
variable to neutralize exposure to CSA
case-related personal and professional
challenges; it requires vigilant practice. The acronym for this dynamic
variable is ACT NOW (Acknowledge,
Confront, and Treat to Neutralize
Our World). In order to fulfill criteria
as a positive self-care practice, two
conditions are required: the activity
must result in reduced injuries and
the reduction must be unrelated to
defensiveness.
ACT NOW. ACT NOW is an acronym
for a self-guided cognitive-behavioral
intervention to monitor and treat disruptions to ones professional and social
adjustment as a result of responding
to CSA cases. The cognitive element is
acknowledging case-related facts, situations, and emotional reactions that may
challenge ones professional or social
adjustment. The behavioral element comand marriage license fees (SB 5 (1993)
raised marriage license fees by $4 to
help fund shelters), are intended to
improve law enforcement responses to
DV. Prosecution is still problematic as
victims often refuse to testify or instead
defend their abusers. Victims, especially
women, must consider practical concerns, such as financial support and
their family members, among other
things, and those concerns sometimes
override their initial desire to charge
their batterer.
Other reforms include the following:
Require police officers who are
responding to domestic violence calls
to provide the victim with telephone
numbers and information about other
available services;
Require officers beyond the rank of
supervisor to complete an updated
course for domestic violence every
two years;

May/June 2009
prises two elements. The first behavioral
response is confronting the disruption.
Confrontation translates into disclosing
the disruption to ones partner, friend,
colleague, and/or supervisor. The second
behavioral element is treating the professional or social disruption.
Acknowledgement. Acknowledging
professional experiences that are disturbing to ones social/sexual adjustment is
the first ACT NOW principle. To measure acknowledgment, the Silent Injury
questionnaire included four items. The
items incorporate three related domains,
namely:
1. Inability to disclose work-related
thoughts to others;
2. Silently harboring work-related
social and sexual challenges; and
3. Completing the questionnaire
prompted the professional to acknowledge new health challenges.
A relatively small proportion of
professionals (26.2%) reported zero
acknowledgment challenges. Aggregate
scores for the four items range from 4
to 27 (M = 12.55; SD = 5.09). Reducing each acknowledgment item to a
binomial variable yields a four-point
scale with a range from 0 to 4 (M =
1.25; SD = 1.05). A linear relationship
exists between obstacles to acknowledging disturbing professional experiences and SI score (F (4, N = 1,033) =
165.43, p < 0.000000).

Eliminate the option of diversion

for domestic violence defendants in
criminal cases;
Encourage the arrests of domestic
violence abusers;
Provide for interpreters in domestic
violence cases, since many occur in
non-English-speaking households;
Establish judicial training for court
personnel involved in domestic violence cases;
Establish domestic violence training
for court-appointed child evaluators;
Allow local governments to notify
crime victims when a suspect is released
from jail (see AB 573 (1985); SB 132
(1995); SB 169 (1995); SB 591 (1995);
SB 982 (1995); AB 2819 (1996); SB
1995 (1996); SB 1983 (1996));
Criminalize stalking, which was the
behavior that led, in part, to Nicole
See DOMESTIC VIOLENCE, next page

2009 Civic Research Institute. Photocopying or other reproduction without written permission is expressly prohibited and is a violation of copyright.

CRIME VICTIMSREPORT

THE

For Criminal Justice Professionals and Providers of Support Services

Volume 13, No. 3

Silent Injuries
Among
Child Sexual
Abuse
Professionals,
Part II
by Robert Emerick

Confrontation
Who do we talk to about
work-related health challenges?
Overall, the proportion of professionals who reported they
are unable to talk to anybody
about their work-related health
challenges was a troubling
15%. This isolation was most
pervasive among law enforcement (25.4%) and prosecuting
attorneys (23.8%). Disclosure is
made to ones intimate partner
(62%) and supervisors (28%).
To investigate the professionals
experiences related to disclosing
work-related trauma symptoms
to another person, respondents
were asked: It seems that my
life got worse when I started talking about work-related trauma.
Of those disclosing work-related
trauma to another person (n =
488), the vast majority (89.8%)
rated the outcome favorably.
Family Support. Three items
collected information about family support (FS) to a professional
disclosing work-related health
challenges. The items address
disinterest, rejection, and urging the professional to seek new
See SILENT INJURIES, page 46

ISSN 1092-6372

Pages 3348

July/August 2009

First Best Chance for Changing the Way

Crime Victims Are Viewed and Treated

25 Years of Progress for the

Victims of Crime Act of 1984
by Carolyn Hightower, M.P.A.
[T]here is no quick remedy to the
innocent victims plight. Only the
sustained efforts of federal, state,
and local governments, combined
with the resources of the private
sector, can restore balance to the
criminal justice system. (Lois
Haight (Herrington), judge, California Superior Court, and chair
of the Presidents Task Force on
Victims of Crime.)
This year marks the twenty-fifth
anniversary of the passage of the Victims of Crime Act of 1984. (42 U.S.C.
10601 et seq.) To commemorate the
anniversary of this congressional effort,
a snapshot of the accomplishments of
this federal statute and its effects on
advancing rights and services for the
roughly 23 million citizens victimized
by crimes annually is appropriate.
(Bureau of Justice Statistics, National
Crime Victimization Survey, Crim.
Victimization Bull. (2007), Michael
R. Rand, BJS statistician; includes
completed and attempted crimes of
violence, i.e., rape/sexual assault, robbery, aggravated and simple assault
for population age 12 and over. Of the
23 million estimated victims of crime,
5.2 million (20.7%) represent victims
of violence.)

High Probability of Victimization

In 1987, the Bureau of Justice Statistics issued a report estimating the
lifetime probability of victimization.
This report concluded:
[B]ased on 1975-1984 annual victimization rates, an estimated five
out of six people will be victims of
violent crimes (i.e., rape, robbery,
and assault), either completed
or attempted, at least once during their lives. (Bureau of Justice
Statistics, U.S. Dept. of Justice,
Lifetime Likelihood of Victimization (Mar. 1987), NCJ-104274,
Herbert Koppel, BJS analyst.)
Even with all the caveats about how
the data should be interpreted and the
limitations delineated by statisticians,
these data were unsettling for most
people, and particularly for those who
had already been victimized and those
most vulnerable to becoming victims of
violent crime. For this group, the report
further indicated that the likelihood of
victimization was high, adding, about
half the population (over age 12) will be
victimized by violent crime more than
once. These data amplified previously
See VICTIMS OF CRIME, next page

ALSO IN THIS ISSUE

Past Cases of Domestic Violence and Future Legislation . . . . . . . . . . . . . . . . . . . 35
Voting Rights for Former Felons? Many States Say, Yes . . . . . . . . . . . . . . . . . 37
This Is My Life Now . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Worth Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Bulletin Board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

2009 Civic Research Institute. Photocopying or other reproduction without written permission is expressly prohibited and is a violation of copyright.

TM

46

The Crime Victims Report

See VICTIMS OF CRIME, from page 45

cutting-edge training and technical

assistance, and make information available to crime victims, victim advocates,
and allied professionals. The Office for
Victims of Crime deserves credit for its
efforts to administer this federal statute
in accordance with the spirit and intent
of Congress, and for attempting to hold
true to the basic tenets of the Presidents
Task Force on Victims of Crime report.
The office should also be recognized for
its efforts to efficiently use Crime Victims Fund dollars by looking at effective
alternatives for carrying out its mission.
The offices implementation of the OVC
Resource Center and the OVC Training and Technical Assistance Center
greatly enhanced the effect of VOCA
and its ability to improve the status
of crime victims. The OVC homepage
and the resources accessible through
this sitethrough links to initiatives
like the Victim Assistance Training
Online, the VictimLaw database, and
the online victim services directory, as
SILENT INJURIES, from page 33

employment. Almost one-third (29%)

of the professionals reported they believe
nobody in their family wants to listen
to their health-related work disclosures
and an equivalent proportion reported
that they felt rejected by family members
when they attempted to disclose. Almost
20% reported that their family has asked
them to seek a new profession. About half
(53.2%) of the professionals reported
they are unchallenged by any of the three
family support dynamics. Cumulative
scores range from 3 to 21 (M = 8.02;
SD = 4.53). Lower scores correspond
to perceiving family support favorably
(R = 3 to 12). Higher scores correspond
with possibly problematic family support
(R = 13 to 21). The items are reasonably
correlated (Cronbachs Alpha = 0.6773)
given the professionals diverse family
systems. Ones judgment regarding family support was unrelated to gender and
profession. A linear relationship exists
between family support and SI score (F (3,
N = 1,033) = 133.32, p < 0.000000).)
Administration Guidance. The five items
comprising the administrative guidance
(AG) scale reflect the CSA professionals

well as the government-wide funding

for crime victims via sites like http://
www.Grants.gov/ have simplified
efforts to access information about
programs and funding, and facilitated
the access to resources funded with
Crime Victims Fund dollars. These
and so many of the other initiatives
implemented and instituted by OVC
have had a significant effect on efforts
to meet the needs of crime victims
wherever they may be found. And the
consistent source of funding through
deposits into the Fund and the allocation of these funds by Congress cannot
be understated. This authorization and
allocation (and now appropriation) of
money from the Fund sets VOCA apart
from virtually all other victim statutes
enacted in the 1980s.
The Crime Victims Fund is what
made it possible over the past
decades to fund victims rights
and services across the nation. It
was a huge step forward, just huge
and immeasurable. And that really
enabled us to do so much. (Aileen
Adams, OVC Director, 1994-1997,
perception of administrative availability,
authenticity, and responsiveness to mediating work-related trauma. Cumulative
scores range from 5 to 34 (M = 12.71; SD
= 7.25). Lower scores correspond to perceiving administrative guidance favorably
(R = 5 to 15) and higher scores correspond
with possibly problematic administrative
guidance (R = 16 to 34). The items are
reasonably correlated (Cronbachs Alpha
= 0.8438). Ones judgment regarding
administrative guidance is unrelated to
gender and profession. The relationship
between administrative guidance issues
and SI score is significant.
Generally, CSA professionals hold
favorable judgments about their
supervisors. More than half of the
professionals (59%) perceive their
supervisor as available, authentic, and
responsive. Avoidant (20%) and disingenuous (17%) were the two most
pervasive problematic views the professionals held about administrative
guidance. Administrators who neglect
to provide pre-case assignment training
are more likely to be viewed negatively
than are administrators providing
pre-case assignment training. Overall,
more than one-third of the professionals (38.7%) were assigned CSA cases

July/August 2009
in An Oral History of the Crime
Victim Assistance Field.)
Carolyn A. Hightower served as the principal
deputy director, Office for Victims of Crime
within the U.S. Department of Justice from 1994
to 2007. She started her federal service career
in OVC as a Presidential Management Fellow
in 1984 and served there in several capacities
including as the director of the State Compensation and Assistance Division (1990-1993), acting director (1993-1994), and program manager
(1986-1990).
To provide a broader perspective of progress
observed since VOCA was enacted in 1984,
background information and reflections were
sought from a select group of victim advocates,
public policymakers, and national victim representatives. The thoughts and opinions gleaned
from these representatives helped informed this
article. Special thanks are extended to Steve
Derene, Dan Eddy, J.D., Gregory C. Brady,
J.D., John W. Gillis, Lois Haight (Herrington),
J.D., Jane Nady Sigmon, Ph.D., Steve Siegel,
John Stein, J.D., Kathryn Turman, and Marlene
Young, J.D., Ph.D., who generously shared their
time to offer perspectives about VOCA . Over
the past 25 years, each has played an integral
role in the implementation and expansion of
VOCAs effect on the field.

without specific training. Law enforcement and prosecuting attorneys were

the two professions most likely to
begin their professional service delivery
without CSA case-specific training.
Disclosure to Supervisors. Is it personally and professionally safe to disclose
professional trauma to ones supervisor?
Most CSA professionals (83.5%) believe
it is. Law enforcement personnel (25%)
and prosecuting attorneys (24%) are the
two professions most likely to believe differently. Sex offender therapists comprise
the smallest proportion of professionals
(7.9%) to question their personal and
professional safety in disclosing professional trauma. Overall, 291 CSA professionals indicated their coping responses
to profession-related trauma included
disclosure to their supervisor. Gender
and profession were unrelated to utilizing
ones employer or supervisor as a coping
response to case-related trauma. Most
professionals (70.8%) utilizing this coping skill rate the experience positively. It
is noteworthy to point out those professionals who report never disclosing profession-related trauma to an employer or
supervisor judge administrative guidance
See SILENT INJURIES, next page

2009 Civic Research Institute. Photocopying or other reproduction without written permission is expressly prohibited and is a violation of copyright.

July/August 2009
BULLETIN BOARD, from page 48

Platte Canyon High School in Colorado focuses on lessons learned

SILENT INJURIES, from page 46

more favorably than do professionals

whom report disclosing their trauma
challenges to a supervisor.
Professional, Personal History Factors. Five professional history factors
and one personal history factor significantly contributed to professionals judging administrative guidance negatively.
The professional history factors were
as follows:
1. Being assigned CSA cases without
pre-case assignment training;
2. I n c r e a s i n g n u m b e r o f y e a r s
experience;
3. Having face-to-face contact with
child molesters and child victims;
4. Beginning CSA casework at age 30
or younger; and
5. Number of boundary violations.
A childhood sexual abuse history
was the single personal history factor.
The Silent Injuries data set strongly
indicates child sexual abuse program
administrators are charged with
complex responsibilities. Not only are
administrators responsible for developing and maintaining services to reduce
child sexual abuse incidence rates, they
have a responsibility to acknowledge
health risks to their personnel and to
provide services that mediate potential
injuries. Administrators who neglect
to acknowledge and mediate health
risks to their personnel are simultaneously compromising societal efforts to
identify and protect abused children.

Personal Health Care

The average SI score (m = 106.55;
sd = 39.62) among the professionals
(n = 428) indicating their health care
habits include aerobic conditioning at
least two times per week is less than
the average score (m = 115.52; sd =
46.24) among the professionals who
do not have an aerobic conditioning
program, t(1,031) = 3.26 (p < 0.001).
Though fewer professionals report having a biweekly resistance-training program (n = 207), such training appears
to serve as a positive self-care practice.

The Crime Victims Report

47

from the response to the shootings,

and is a good resource to help communities and states plan in advance
to respond to victims of acts of mass

violence. The report is available at

http://DCJ.state.co.us/ovp/Docu
ments/OVP%20General/Bailey_Proj
ect_Lessons_Learned.pdf.

The mean score (m = 105.82; sd =

39.40) among professionals practicing
a resistance-training program is less
than the average score (m = 113.31; sd
= 44.76) observed among professionals without such a health care practice,
t(1,031) = 2.20 (p < 0.05).
Self-Defeating Coping Responses. Selfdefeating coping responses are equally
measurable. The three most glaring
impaired coping responses are:
1. Neglecting to take a respite from
ones professional responsibilities;
2. Annually experiencing 10- to
15-pound weight variances; and
3. Using alcohol weekly with ones
colleagues.
The proportion of professionals
reporting they lack time to take annual
vacation leave is substantial (39.7%)
and unrelated to social desirability scale
score (2 (2, n = 1,033) = 1.62, p > 0.05).
Professionals neglecting to utilize their
annual leave score significantly higher
on the SI scale than their colleagues who
utilize this health care practice, t(1,031)
= 10.22 (p < 0.00000). Over one-third
of the professionals (35%) reported
annual 10- to 15-pound weight variances. Professionals reporting annual
weight swings scored significantly
higher on the SI scale (m = 128.40; sd =
47.52) than professionals denying such
weight shifts (m = 110.56; sd = 43.88),
t(1,031) = 6.06 (p < 0.00000).The proportion of professionals acknowledging
they drink alcoholic beverages with colleagues at least one time per week was
relatively small (7.4%) and related to
social desirability scale score (2 (2, n
= 1,033) = 11.07, p < 0.005). The proportion of professionals acknowledging
weekly alcohol use ranged from 4%
among possibly defensive professionals, to 7.3% among the moderately disclosing professionals, to 10.8% among
the highly open group. However, the
relationship between this impaired
coping response and SI scale score is
anything but insignificant. On average,
the weekly use of alcohol professionals
scored 131.89 (sd = 46.99) in comparison to an average score of 110.21 (sd =
43.19) among the professionals denying

weekly alcohol use with colleagues,

t(1,031) = 4.19 (p < 0.00005).
Counseling. Almost half the professionals (48%) indicated they have sought
counseling from undefined resources.
Seeking counseling to aid coping skills
is related to ones profession. The law
enforcement professions are the least
likely to seek counseling: prosecutors
(59%), probation officers (53%), and
police officers (52%). Professionals providing counseling services to children are
the most likely to seek assistance with their
coping skills: victim counselors (73%) and
offender-victim counselors (69%).
Overall, a majority of professionals (76.2%) believe their agency
should provide counseling services to
minimize trauma issues. Professionals
reporting obstacles to acknowledging trauma or satisfying confrontation resources are more supportive of
counseling services than the colleagues
who report fewer acknowledgment
and confrontation challenges. Almost
one-third (31.6%) prefer anonymous
counseling services. Trauma symptoms
that increase the likelihood a professional endorses anonymous counseling
services include experiencing terror
upon receiving a new case assignment,
consensual sexual touching causing
intrusive case fact memories, reliance
on avoidant behavior to reduce further
toxin exposure, and hypervigilance. In
other words, the relationship between
PTSD features and desiring anonymous counseling is significant.
Mr. Emerick has developed and managed
treatment programs for child sexual abuse
survivors and perpetrators in the United States
and Canada. His clinical and research practice
yielded abuse history factors among adolescent
and adult sexual abuse survivors that identify
children at higher risk to act out sexually. In
addition to his clinical and research practice,
he teaches child sexual abuse professionals
about sex offender investigation, treatment,
and supervision, and has made presentations on Silent Injuries to child sexual abuse
professionals at various state, provincial, and
national conferences. For more information
regarding Silent Injuries and to complete the
Silent Injuries Questionnaire, go to www.
SilentInjuries.com.

2009 Civic Research Institute. Photocopying or other reproduction without written permission is expressly prohibited and is a violation of copyright.

September/October 2009

The Crime Victims Report

53

Silent Injuries Among Child Sexual Abuse

Professionals, Part III
by Robert Emerick*
Editors Note: The first part of this
article, opening the discussion on
stress among child abuse professionals, appeared in the May/June issue
of CVR. (Robert Emerick, Silent
Injuries Among Child Sexual Abuse
Professionals, Part I, 13 (2) CVR 19
(May/Jun. 2009).) The second part of
this article discussed the Silent Injuries
data set. (Silent Injuries Among Child
Sexual Abuse Professionals, Part II,
13 (3) CVR 33 (Jul./Aug. 2009).)
Responding to CSA cases requires
professionals to confront social and
sexual deviance as it manifests within
the child molester. The exposure can
be direct, such as interviewing or
physically examining a child, offender,
or both. The exposure also can be
indirect, such as reading a case file,
listening to a case staffing, or viewing
images (e.g., child pornography). Data
anonymously collected from 1,033
CSA professionals clearly indicates
that social and sexual deviance as it
manifests within the child molester is
an extreme traumatic stressor. Exposure to the stressor creates a confluence
of normative attitudes and unexpected
psychological, social, and sexual
boundary violations. Each boundary
violation requires the professional
to make adaptive adjustments. Professionals whose adjustments fail to
restore pre-exposure health demonstrate disruption to their cognitive and
social adjustment. For some, the expo*Mr. Emerick has developed and managed
treatment programs for child sexual abuse
survivors and perpetrators in the United States
and Canada. His clinical and research practice
yielded abuse history factors among adolescent
and adult sexual abuse survivors that identify
children at higher risk to act out sexually. In
addition to his clinical and research practice,
he teaches child sexual abuse professionals
about sex offender investigation, treatment,
and supervision, and has made presentations
on Silent Injuries to child sexual abuse professionals at various state, provincial, and national
conferences.
For more information regarding Silent Injuries and to complete the Silent Injuries Questionnaire, go to www.SilentInjuries.com.

sure yields specific sexual injuries that

can negatively affect the professionals
sexual adjustment and intimate relationships. Exposure to the stressor is
not uniform. However, the exposure
effects to deviance are comparable
among all CSA professions and there
are personal and professional history
factors, administrative practices, and
self-care habits that can mitigate or
aggravate the development of symptoms that characterize exposure.

ACT NOW
ACT NOW is the acronym for the
three distinct responses that measurably reduce ones potential injury
vulnerability. The first response is
acknowledging the potentially harmful
effects of exposing healthy people to
deviance. This responsibility is shared
by program administrators and professionals. First, CSA administrators are
responsible for identifying CSA cases
as a specialty service that has inherent
health risks. Second, administrators
are responsible for assuring CSA professionals are appropriately trained to
deliver their specialized service. Being
appropriately trained to provide specialized service also means possessing
self-care strategies that conserve ones
health and professional competence.
Program administrators who neglect
to acknowledge the health risks related
to CSA service delivery are failing to
secure the professionals consent to
risk his or her personal and family
health. Professionals are responsible
for acknowledging disruption to their
social and sexual adjustment.
Confronting cognitive, emotional,
and social/sexual injuries is the second
phase to ACT NOW. Facilitating this
phase begins with pre-case assignment
training. Given the personal injuries
CSA professionals may incur and the
potential for these injuries to disrupt
intimate relationships, it is advisable to include the CSA professionals
intimate partner in the acknowledgment phase. Most professionals prefer
to confront their injuries with their
family or intimate partner and seek

administrative guidance when their

preferred coping response fails. The
significance to this observation cannot be overstated. Generally, it means
CSA professionals seek administrative
guidance when their exposure effects
to deviance have evolved into complex
cognitive, social, and sexual features.

Treatment
Treatment begins with daily health
care and may include utilizing counseling services. Self-care habits that
clearly demonstrate professional conservation benefits include utilizing
annual leave, diversifying professional
responsibilities, aerobic and resistance training at least twice a week,
and maintaining ones body weight
within a range that is no greater than
10 pounds less or more than optimal
body weight. Treating personal or
professional toxic experiences may
include one or a combination of three
possible treatments. The common
objectives to each treatment are communicating about the toxic experience
and disrupting social/sexual isolation.
Ultimately, this translates to neutralizing the toxin. Level One treatment
is talking to family, friends, intimate
partner, and/or supervisor. This action
promotes intimacy and social inclusion and neutralizes the toxin by
identifying the stressor as exposure
to social/sexual deviance. In the event
one is unable to clearly describe the
disruption to social/sexual adjustment or ones Level One resources are
unable to help the professional restore
balance, then the injury may progress.
Professionals who are unable to clearly
describe their exposure effects to anybody are at increased injury risk.
Level Two treatment is attending
agency-provided counseling. Most
CSA professionals (75%) believe this
support service is essential to reducing
Silent Injuries. This service is best considered a brief strategic intervention
to neutralize toxic effects that persist
despite the Level One treatment. Level
See SILENT INJURIES, next page

2009 Civic Research Institute. Photocopying or other reproduction without written permission is expressly prohibited and is a violation of copyright.

54

The Crime Victims Report

SILENT INJURIES, from page 53

Three treatment is attending anonymous counseling. Professionals experiencing critical injuries to their sexual
response cycle, controlling behavior as
child caretakers, and highly charged

RECOVERING, from page 52

the school and teachers to offer support. Businesses donated food, beverages, and whatever was needed. The
high school started a program that
encouraged students to be kind to
one another in memory of Emily. The
program was called Random Acts
of Kindness. Parents and community volunteers were stationed at the
entryways to each of the schools and
all visitors had to sign in and wear a
visitors badge. This volunteerism not
only provided more security on the
school campus, but also provided parents with a constructive way to help
out.

Long-Term Activities
A drop-in center opened February
2007 to provide high school and middle school students with a safe and
nurturing environment. The school
district continues to provide free
school bus rides after school to the
center, which offers a variety of activities as well as a place to spend time
with friends and get help with homework. A variety of safety issues were
addressed, including a vulnerability
assessment for the school district, a
School Safety Advisory Committee,
joining the Safe2Tell hotline program,
and the development of a new parent notification system. Mental health
services continued to be offered to students, parents, first responders, and
community members. Experts from
the National Center for School Crisis
and Bereavement came to the Bailey
community and met with teachers,
administrators, and parents twice during the first few months after the tragedy. They continued to stay in contact
with the school administrators.
A full-time counselor was hired
to work at the high school and middle school. Individual and group
counseling was provided and offered
through spring 2009. A website was

September/October 2009

personal CSA memories are most

likely to endorse this support service.
CSA professionals are exposed to
social and sexual deviance. Unsurprisingly, the exposure can injure the
professionals social and sexual adjustment. To conserve CSA professionals,

it is critical that CSA training precedes case assignment. The training

should acknowledge potential health
risks and introduce the ACT NOW
process to help professionals habituate healthy personal and professional
coping responses.

designed to help members of the Bailey community learn about and cope
with traumatic stress reactions. The
girls who were taken hostage, along
with their teacher, designed and sewed
a quilt that hangs in the library of the
Platte Canyon High School.

The local agencies, including victim

services nonprofit agencies, had well
established relationships and there
was a trust and confidence among the
key players. Local agencies had developed a plan for a response to a critical
incident and had completed a practice
scenario with the students just a few
weeks before the tragedy. The school
community was open to assistance
from outside agencies, and those outside agencies respected the fact that
those in the Bailey community were
the leaders and the decision-makers.
A resource list was compiled that
included written materials and websites that provided resource information for a variety of audiences.
Accessing financial resources is key.
Seeking help from national organizations, such as the National Center
for School Crisis and Bereavement,
is another way state and federal personnel can assist. The representatives
from the U.S. Department of Justice,
Office for Victims of Crime, and the
U.S. Department of Education were
extremely helpful.
School districts and victim services
agencies took the lead in conducting an
assessment of what human and financial resources were needed to help the
primary and secondary victims of the
crime, as well as the community, during and after the crime. This assessment was ongoing and incorporated
into the overall response plan.
All available victim services components were utilized, including victim
services through local law enforcement,
community mental health agencies,
community nonprofit organizations,
private providers, and school-based
counselors.

Great Need for Financial

Resources
After any crisis, the needs are going
to exceed available resources, especially in a smaller community. In the
Bailey community, financial resources
were needed for additional counselors,
mental health therapists, substitute
teachers, security needs, communication support, and financial assistance
for victims. The Colorado Division of
Criminal Justice assisted the Bailey
community in applying for and receiving grants from the U.S. Department
of Justice, Office for Victims of Crime,
Anti-terrorism and Emergency Assistance Program, the U.S. Department of
Education, Project School Emergency
Response to Violence (Project SERV)
Grant Program, Victims of Crime Act
(VOCA) Assistance Grant Program,
a local Victim Assistance and Law
Enforcement Board, and the Edward
Byrne Memorial Justice Assistance
Grant Program. Through the generosity of individuals, some of whom
did not even live in Colorado, many
donations were made to the school
and the community. Friends of the
Keyes family immediately set up the
I Love U Guys Foundation and worked
closely with school officials to determine how to collect and distribute
funds.

What Worked for the Bailey

Community
The response from the school district, law enforcement, and victim
services was extraordinary. The cooperation among all of the agencies was
outstanding and will be held out as a
model for Colorado communities.

Focus on Being Kind

Those of us from outside the Bailey community learned so much from
those in the Bailey community: The
See RECOVERING, page 56

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